Zika: The Battle Against the Uncontained Virus

Recife, Brazil. A woman just gave birth to a baby boy, bringing new life into this world and marveling at the miraculous event. However, this joyous moment soon turns into one of devastating sadness.

Such was the case of Rafaela Oliveira de Santos when her second child was born. She recalls back to that unforgettable day: “At first, I wasn’t concerned because the doctor where I delivered didn't tell me there was anything wrong.” However, there was something awfully wrong indeed. Rafaela had been infected by the Zika virus during her pregnancy, and her baby, Luiz Felipe, was born with microcephaly (a brain condition where the infant’s skull fails to properly form and remains undersized, leading to an underdeveloped brain and a head size that is much smaller than normal). Doctors informed Rafaela that her son could lose his sight, hearing and ability to walk, perhaps even resulting in significant brain damage. It seemed as though her world was falling apart around her.

Our basic understanding of the Zika virus is well established, and we now know far more about the disease than we did when the outbreak began in early 2016. The virus is usually spread by the mosquito Aedes aegypti, a species with population distributions across the world. One in five people who contract the Zika virus develop mild symptoms such as fever, rash, joint pain and red eyes, all of which usually subside after a week or so. Although the manifestations are mild, the true devastation lies in the infection of pregnant women and the development of microcephaly in newborns, as seen in the case of Rafaela’s newborn child. This link between Zika-infected pregnancies and microcephaly has been confirmed by current, 2016 research studies as well.

In addition to microcephaly, researchers strongly corroborated the connection between the Zika virus and Guillain-Barre syndrome, a neurological condition where the body’s immune system attacks its own nerve cells to cause paralysis. Dr. Van-Mai Cao-Lormeau examined French Polynesian patients suffering from Guillain-Barre syndrome and found that, of the 42 patients affected by the disorder, 37 had experienced Zika symptoms about six days before the onset of the syndrome. Health officials in Latin America have reported that in countries affected by Zika, cases of Guillain-Barre syndrome have also skyrocketed, even up to 877 percent higher in countries like Venezuela. Still another potential consequence of the Zika virus is a wide host of metal illnesses, including schizophrenia, autism and bipolar disorder. Although most debilitating mental conditions cannot be attributed to one simple cause, viral infections in fetuses are thought to be an important trigger that puts infants at higher risk for mental illnesses later in life.

Currently, the Zika virus has already entered the contiguous U.S. and begun to wreak its havoc in Florida. The epicenter of the Zika outbreak has been in Miami, with Zika being transmitted locally there in July. Just this past September, mosquitos found in Dade County, Florida, tested positive as carriers of Zika. The state’s health department has reported 56 cases of local transmission in Florida, yet the numbers are largely underreported since reports exclude those who are not state residents.

Outside of the United States, Zika has spread throughout the entirety of Central America, most of the Caribbean and a good majority of the northern and eastern regions of South America. Puerto Rico lived up to the predictions of an epidemic as poor basic health and environmental services provided a ripe breeding ground for an explosive outbreak; the number of Zika cases there rose from 117 in February to 20,000 in September. However, no country has been hit as hard by the epidemic as Brazil. Researchers believe that soccer fans from French Polynesia (where a major Zika outbreak occurred in 2013) brought the virus to Brazil during the 2014 FIFA World Cup. Since the beginning of 2015, over one million Brazilians suffered from the virus, and approximately 4000 babies have been born with microcephaly. Moreover, scientists fear that the current outbreak in Brazil is so severe that the virus may become endemic to the nation and incorporate itself firmly into the country’s ecological environment.

If the current spread of the disease sounds unfortunate, it gets even worse with future predictions of Zika. In early spring of 2016 the World Health Organization (WHO) estimated that by the end of this year, the virus would infect about three to four million of the world’s population. A new model reported by Nature Microbiology in July estimates much higher numbers—about 93 million infections, and as many as 1.6 million childbearing women, by the conclusion of the Zika epidemic. In the United States, the virus is expected to spread across the Southeastern United States with some cases even surfacing in Texas and Oklahoma.

As with any regional or global epidemic, one usually wonders what efforts are being made to combat the spread of this debilitating virus. The outbreak has grabbed the attention of the British biotechnology company Oxitec, which is developing a genetically modified line of the Aedes aegypti mosquito to combat the natural mosquitoes that carry the Zika virus. The engineered male species can mate with wild female ones, resulting in offspring that die before reaching adulthood. Oxitec’s trials on genetically modified mosquitoes are already underway in South America, and the company claims that wild Aedes agypti populations have been reduced by 82 percent in the city of Piracicaba, Brazil. Health organizations in the U.S. have also joined the fight against Zika. Another possible method of combat is using the aerial spray, “Naled”, to kill adult mosquitos in Miami to curb the outbreak. However, the spray is not without negative consequences as many Miami residents have complained of rashes, headaches, and nausea as side effects of the use of the naled.

Dr. Tom Frieden, director of the CDC, proudly declared the organization’s development of new tests that can confirm the presence of Zika in an infected patient. Currently, CDC scientists and other private companies are also in the process of developing tests that can determine prior infection of Zika in an individual.

Fortunately, vaccines against the Zika virus are in the works and will likely be ready for use by 2018. Potential vaccines are being developed by the National Institutes of Health and by private firms, such Inovio Pharmaceuticals. While the additional requirements of the vaccines’ clinical testing and approval could make them unavailable to the public for a few years, human trials for the vaccines have already begun and large-scale trials possibly will commence in early 2017. According to Nicholas Jackson, the director of the vaccine unit of the pharmaceutical company Sanofi, their technology and research infrastructure has given them a slight jump-start on developing a vaccine, stating “We should be able to slash years off a timeline that would be 10 years or more.”

So what measures can individuals take in protecting themselves against the Zika virus? There are a few things we should know going forward. Since mosquitoes are the primary mode of transmission, the CDC advises travelers going to countries where Zika is prevalent to wear long-sleeved shirts, long pants and use EPA-approved insect repellent. Most importantly, the one thing we certainly cannot afford to do is delve into a state of unbridled fear and panic. National Security Analyst and former assistant secretary of the U.S. Department of Homeland Security, Juliette Kayyem, writes, “While it is important that we be prepared, it is important that we remain clear-eyed and not fall victim to the fear and myth surrounding the virus.” We must remember that Zika has been around for a long time and the vast majority of those infected by Zika (besides pregnant women) experience mild or no symptoms. Beyond taking the fundamental steps in anticipation of the virus, the rest is beyond our control. Unnecessary media fright and rumors will only worsen the situation. The most practical strategy, according to Kayyem, is to “Support efforts abroad; minimize the risk to citizens here; and keep our heads on straight.”

Hopefully the world can learn from cases like Rafaela Oliveira de Santos and her newborn son and become more aware of this debilitating virus. Our increased awareness from Rafaela and Luiz’s story is enabling the world’s top scientists to work together to develop vaccines and preventative measures to ensure that future generations will not be burdened by this devastating illness.